is a Addiction (substance Use Disorder) in Yucaipa, California. practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for is 1225247273. The last update date is .
's current location address is 13333 3rd St, Yucaipa, California. You can contact this provider via phone number 9097029492. The mailing address for is 13333 3rd St, Yucaipa, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 13333 3rd St, Yucaipa, California |
| Phone Number | 9097029492 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1225247273 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 13333 3rd St |
|---|---|
| City | Yucaipa |
| State | California (CA) |
| Post Code | 923995032 |
| Phone Number | 9097029492 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | I2012106 |
|
Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| RS5273 | CA | SIMON STAFF NUMBER |
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